Traditional Chinese Medicine Primer

Traditional Chinese Medicine (TCM) is a holistic medical system that dates back over 3,000 years. Chinese medicine has a long history of treating skin conditions, starting in the earliest books over three millennia ago.

TCM has its own intricate language, logic, and imagery for understanding health and disease. Health is defined as a state of harmony within a person as well as between the person and the universe. The TCM physician’s goal is to understand how a patient’s internal landscape, environmental factors, and skin symptoms paint a picture of the particular disharmony affecting that person.  Before exploring TCM dermatology in depth, it is important to understand a few basic concepts about health and illness. 

The Basis of Health: Yin and Yang 

White represents yang and the black areas represent yin

The concept of harmony can be understood through the philosophy of yin and yang. Yin and yang represent complementary pairs- light and dark, hot and cold, and wet and dry. These opposites rely on each other to exist and provide a counterbalance for one another.

In Chinese medicine, yin and yang also refer to the vital substances of the body. Health is achieved when yin and yang are in balance. Disharmony develops and disease occurs when yin or yang are out of balance.  

Qi: The Vital Energy

When we are in balance, this allows for optimal production and circulation of qi, our vital energy.  

As the universal energy in all things, qi comprises the building blocks of the universe. While quite mystical in origins, qi is a very practical idea within medicine. All people and animals use qi to stay healthy. The heart uses qi to pump blood, the liver uses qi to detoxify, digestion uses qi to obtain nutrients from food and get rid of waste, and skin uses qi to protect the body from illness and in order to look beautiful and radiant. 

We are healthy when qi is abundant and circulating throughout the body. A lack of qi or stagnation in its flow leads to illness. 

Healthy qi allows the body to produce sufficient blood which is another building block of health. Together, qi and blood work to nourish and moisten the skin and protect the body from pathogens.

Table 1. Vital Substances

How Do We Get Sick?

Illness occurs when we are not in balance. A disharmony can develop within an individual or between the individual and the environment. Both often occur simultaneously.  

It’s easy to see that the natural world has qi. We can feel the positive energy of the warm sun, beautiful sunsets, and the night sky. We also feel negative energy during drought, torrential rainfall, heat waves, and wind storms. Doctors used observations of the natural world to describe the disease they saw manifesting in their patients. For example, heat, humidity (referred to more often as dampness), cold, dryness, and wind are climatic pathogens which attack the body or develop within the body and cause disease.

The internal balances develop when yin, yang, qi, and blood are in disharmony.

Table 2. Climatic Pathogens

TCM Dermatology: How to Identify the Disharmony in the Skin

The TCM doctor aims to understand how a patient’s vital energy reacts with climatic pathogens through observing skin symptoms and overall health to paint a picture of the particular disharmony affecting that person.  

In TCM, one disease has many possible causes. Eczema, for example, may be caused by heat or dampness (among other imbalances) depending on how it appears and the accompanying symptoms. 

Each of the climatic pathogens has their own characteristics within dermatology. For example, heat causes redness on the skin while dampness may cause swelling (among other symptoms). Qi and blood disharmonies also disrupt skin health. Too little qi leads to undernourishment of the skin and dryness. When the qi is stagnated, it is not flowing, and skin may develop dark spots. Disharmonies of qi and blood allow for pathogenic qi to develop within an individual or to attack from outside, in the environment. 

An individual and the universe are energetically intertwined and so are always influencing one another.  

Health of the Skin: The Whole Picture

One way TCM is a holistic medicine is because it views the specific condition of the skin as it relates to the health of a person as a whole. Chinese medicine has developed its own unique physiology by which to group functions of the body together to better understand their interconnected relationship. Emotional and physical health are also interwoven. While the organs have the same names as the biomedical organs, note that some functions differ between the systems.    

Table 3. Vital Organs

Skin Organs

Hair

• Healthy: Kidney qi, blood, and yin nourish the growth of the hair.
• Imbalances: Kidney qi and blood deficiency creates a lack of nourishment and leads to hair loss/thinning and graying.
• Liver qi stagnation creates a lack of nourishment and causes hair to fall out.

Blood vessels

• Healthy: Heart qi moves blood through the vessels, nourishing the skin.
• Imbalances: Qi and blood stagnation lead to lack of circulation and the development of dark spots.
• Spleen qi deficiency results in qi that cannot maintain healthy blood vessels and leads to bleeding.

Sebaceous Gland

• Healthy: Qi and blood moisten the skin.
• Dampness and heat result in an overproduction of oil and inflammation of glands.
• Qi and blood deficiency result in dry skin

Collagen and Elastin

• Healthy: Qi and yang raise collagen producing healthy full skin.
• Imbalances: Kidney qi and yang deficiency leads to a lack of collagen production.

Sweat Glands

• Healthy: Ample qi, blood, and body fluids produce sweat.  Lung qi regulates the opening and closing of pores.
• Lung qi deficiency or heat leads to excessive sweating.
• Dryness leads to limited sweating which can put the health of your skin at risk.

Learn More: 5 Elements (Also called 5 Phases)

Another TCM lens to understanding health and harmony is the 5 elements. It is based on the idea that the elements make up the universe also make up us and our bodies.  Balance, movement, and the relationship of these elements reflect and influence health. Each of the elements are related to specific functions and organs in the body.  The relationships of the elements to one another are another perspective on the interrelationship between functions of the body which can inform a diagnostic or therapeutic approach.

 

The generating and restraining cycle is an approach for understanding the interrelation of the body’s functions. For example, wood generates fire and controls earth.  Wood supports fire’s functions but restrains earth from overworking. If wood becomes too weak, it cannot support fire leading to poor circulation.  If wood becomes too strong it will over control earth damaging the digestion function.